This activity is linked to activity ID 19011.08, 18989.08.

HPH Partners will increase access to basic health care and support for people living with HIV/AIDS

(PLWHA) as well as respond, as feasible, to the needs of the whole household. Field staff will be trained to

respect patient autonomy, privacy, and cultural values and to work to enhance quality of life for PLWHA and

their families.1 In addition, the field staff will teach family members how to provide basic care. This will

reduce ostracism and make the care of PLWHA both on-going and sustainable. Through home based care,

the program will deliver a full range of services: clinical care, psychological care, spiritual care (e.g. use of

life maps), and social care. HPH Partners will focus on providing care to people affected by HIV or TB but

will not provide treatment for TB. Using regional guides for prevention and care resources, HBC staff will

connect beneficiaries to area resources.

BACKGROUND:

These activities represent a fuller development and extension of an initiative begun during the last four

months of 2007 under the New Partner's Initiative with USAID administered President's Emergency Plan for

AIDS Relief (PEPFAR) funds. Implementation of BHCS activities is being carried-out by six partners (as

originally described) under the guidance and support of WHI.

ACTIVITIES AND EXPECTED RESULTS:

Key activities include:

1.Identification of clients through community networks, mobile and free standing clinics, community events,

tuberculosis directly observed therapy (TB-DOT) programs, youth to youth (Y2Y) groups, and other

community and faith-based organizations, schools, and churches.

2.Training and retraining for field staff in: clinical care services (as needed), home visit scheduling and

recordkeeping, psychosocial support, and counteracting caregiver burnout. Field staff will also receive a list

of prevention and care resources to which they can connect clients and their families.

3.Weekly home visits (will be made more frequently as necessary). Visit records will be maintained and

stored in a confidential location.

4.Linkages to supplementary care services including "prevention for positives".

Participants will be considered reached when they have received clinical care services.

EMPHASIS AREAS:

Community Mobilization/Participation 15 - 20%

Development of Network/Linkages/Referral Systems 15 - 20%

Information, Education and Communication 10 - 15%

Linkages with Other Sectors and Initiatives 25 - 35%

Training 20 - 25%

Food/Nutrition Support 10 - 15%

TARGETS:

Number of individuals provided with general HIV-palliative care including TB/HIV

6,384 (3,192 Male/3,192 Female)

Anticipated breakout by Department = Artibonite (756); Central Plateau (966); West (1890); South (1722);

and South East (1050)

TARGET POPULATIONS:

PLWHA or TB

HIV/AIDS-affected families

Community and religious leaders

Community and faith-based organizations

Health care providers

Providers of related and beneficial prevention and care resources

KEY LEGISLATIVE ISSUES:

Increasing gender equity by targeting women and collecting data to show breakdown of women and men

receiving BHCS care

Addressing male norms and behaviors through outreach, education and support of PLWHA

Reducing violence and coercion through outreach, addressing stigma, and support activities for PLWHA

and caregivers

COVERAGE AREAS:

BHCS programs in the West and South East, launched in 2007, will be extended into Artibonite, Central

Plateau and South by 2008.

This activity is linked to activity ID 19011.08, 18987.08.

SUMMARY:

HPH orphan and vulnerable children (OVC) activities address the physical, social, emotional, and

intellectual needs of OVC, with emphasis given to emotional and intellectual support for OVC and

caregivers. This emphasis is realized, in large part, by sensitizing the entire community—community and

religious leaders, caregivers, and community members—to the needs of the OVC; and, empowering

churches, community and faith based organizations (C/FBOs), and schools to have their own OVC

programs to assist local OVC with basic needs. Effectiveness also necessitates responding to the physical,

social, intellectual, and emotional health needs of OVC and caregivers through educational assistance,

agriculture/nutrition projects, social clubs with emotional care component, literacy classes, and other

caregiver support.

In this program area, as in all others, HPH will leverage linkages with its other programmatic initiatives.

Prevention activities will help to identify OVC and address stigma; as appropriate OVC and caregivers will

be encouraged to be tested and receive counseling; and, OVC will be connected to other care and social

service programs.

BACKGROUND:

These activities represent a fuller development and extension of an initiative begun during the last four (4)

months of 2007 under the New Partner's Initiative (NPI) with funding from the President's Emergency Plan

for AIDS Relief (PEPFAR) administered by USAID. Implementation is being carried-out by the original

seven (7) partners under the guidance and support of World Hope International (WHI).

ACTIVITIES AND EXPECTED RESULTS:

The first necessary activity of HPH Partners is to harness the energy of churches, schools, and other

community- and faith-based organizations to identify and serve vulnerable OVC/families. These outreach

activities also identify potential caregivers who can be trained, equipped, and resourced to support OVC.

As their primary activity in serving OVC and caregivers, HPH programs will emphasize education. OVC

infected or affected by HIV will benefit from school fees for primary education or vocational training

depending on their age group. Literature demonstrates the correlation between education and HIV

prevention—as education increases, the likelihood of becoming infected decreases. In addition, increasing

literacy of caregivers for OVC involved in programs increases their potential to stay in school. HPH will

continue to utilize skilled professional volunteers to provide teacher training, as occurred in the fourth

quarter of 2007, as country conditions allow.

HPH Partners will also invest in agriculture and nutrition programs as they have been shown to improve

food security and are a key recommendation for OVC in Haiti. HPH will also link with Title II (PL-480)

partners and the World Food Program to address the food insecurity issue in families with greater risk and

vulnerability.

Support clubs (social/homework) for OVC will also be established to help meet the social and emotional

needs of children who have often been ostracized and wounded by loss. Emotional support is also

provided to caregivers (in part to address stress and burnout). Experience has taught that OVC care suffers

unless caregivers receive this kind of emotional support.

HPH will also provide increased access to health care to its OVC population. OVC will be referred to clinics

for basic pediatric care (immunization, Vit A. Supplementation, de- worming, growth curve follow -up etc..).

HIV infected children will be referred to health centers where they can be treated for opportunistic infections

and put on pediatric ART when eligible.

OVC goals will be considered reached when they receive two of the above services. Caregiver goals will be

considered reached when they receive one of the above services.

EMPHASIS AREAS:

Community Mobilization/Participation 20 - 25%

Development of Network/Linkages/Referral Systems 10 - 15%

Information, Education and Communication 15 - 20%

Linkages with Other Sectors and Initiatives 25 - 35%

Training 15 - 20%

Food/Nutrition Support 10 - 15%

TARGETS:

9,843 (4,921 male/4,922 female) OVC who are served.

3,282 caregivers/caretakers trained in caring for OVC

Anticipated breakout by Department = Artibonite (1722); Central Plateau (1491); West (4158); South (3948);

and South East (1806)

TARGET POPULATIONS:

OVC

HIV/AIDS-affected families

Community and religious leaders

Community and faith-based organizations

Providers of related and beneficial prevention and care resources

Educational Institutions & teachers

Experienced teachers who are equipped/resourced to train other school teachers

KEY LEGISLATIVE ISSUES:

Increasing gender equity by targeting women and collecting data to show breakdown of women and men

receiving OVC care

Addressing male norms and behaviors through OVC education and support

Reducing violence and coercion through outreach, addressing stigma, and support activities for OVC and

caregivers

COVERAGE AREAS:

OVC programs in the West and South East, launched in 2007, will be extended into Artibonite, Central

Plateau and South during 2008.

This activity is linked to activity ID 18989.08, 18987.08.

SUMMARY: Haitian Partners for Health (HPH), a sub-partner of World Hope International (WHI), counseling

and testing activities are aimed at increasing participation in CT by discordant couples, their family

members, youth and other at-risk persons. CT activities leverage HPH prevention activities (including

community/recreational events), HPH orphan and vulnerable children (OVC) programming, and palliative

care (HBHC) initiatives to promote the importance and value of getting tested for HIV. Sensitizing

community and religious leaders, including addressing stigma, is critical to the success of CT activities and

is integrated into all HPH programmatic activities. In each targeted community, appropriate prevention and

care resources are identified and listed in order to be used in pre- and post-test counseling.

BACKGROUND: CT activities are the last-developing programmatic dimension of WHI's three-year grant

under the New Partner's Initiative with PEPFAR funding administered by USAID. During the final four (4)

months of 2007 activities focused on partner training, sensitization initiatives, and development of referral

listings. Implementation of CT activities is being carried-out by five Partners (as originally described) under

the guidance and support of WHI.

ACTIVITIES AND EXPECTED RESULTS: There are four primary activities in the CT program:

1.Utilizing an assessment questionnaire to determine the quality of services offered in order to determine

CT sites for HPH activities.

2.Sensitizing community and religious leaders to CT, including explanation of CT and its benefits and the

barriers to CT, including stigma. This is an ongoing activity integrated into all program areas.

3.Recruiting for CT utilizing existing mobile and free-standing clinics, community events, Y2Y groups, home

based care (HBC) visits and other C/FBOs, schools, and churches. This is an ongoing activity integrated

into all program areas.

4.Developing a referral listing of appropriate prevention and care resources to be used in pre- and post-test

counseling and other events.

CT is also seen as the entry point for prevention services for those engaging in high risk behavior and entry

point for care and support for those who test positive. Whenever possible, partners will be encouraged to

test together to avoid inter-couple violence, break stigma, and enable partners who test positive to enter

care together. HPH will look for community role models to talk about and/or role model going for CT as it is

highly effective in breaking stigma and promoting CT within communities. Sensitization of leaders,

communities and populations will be context-driven highlighting the benefits to the targeted audience. CT

will be confidential and compassionate and give PLWHA an action-based response to addressing their

illness. Whenever possible, mental health services will be made available post-test to help buffer shock and

depression. Linkages to care and prevention will be discussed at post-test counseling and a follow-up

appointment will be recommended.

EMPHASIS AREAS:

Commodity Procurement< 5%

Community Mobilization/Participation 30 - 40%

Development of Network/Linkages/Referral Systems 15 - 20%

Information, Education and Communication 30 - 40%

Linkages with Other Sectors and Initiatives10 -15%

TARGETS:

4,400 (2,205 male/2,205 female) who receive HIV counseling and testing and receive their results.

Anticipated breakout by Department = Artibonite (672); Central Plateau (462); West (1470); South (1050);

and South East (756)

TARGET POPULATIONS:

Community and religious leaders

Community and faith-based organizations

Youth and other at-risk persons

Providers of testing services that meet requisite standards

Providers of related and beneficial prevention and care resources

KEY LEGISLATIVE ISSUES:

Increasing gender equity by targeting women and collecting data to show breakdown of women and men

receiving counseling and testing activities

Addressing male norms and behaviors through counseling

Reducing violence and coercion through counseling

COVERAGE AREAS:

Extend coverage in West and South East. Launch activities in Artibonite, Central Plateau and South.